DAVID STOKELY MADDOX II Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000491

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

STOKELY

Last Name

MADDOX

Suffix

Business Name

DAVID STOKELY MADDOX II

Original Issue Date

12/16/1999

Effective Date

08/14/2018

Expiration Date

01/31/2022

City

VERNON HILLS

State

Zip

60061

County

LAKE

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

05/09/2022